a United Medical and Dental Schools of Guy's and St Thomas's Hospitals London SE1 7EH

Accepted 13 February 1997

Introduction

To write prescriptions is easy, but to come to an understanding of people is hard.

Franz Kafka, A Country Doctor

Only about 50% of patients with chronic diseases take their medicines in therapeutically effective doses.1 Although the cost of non-compliance in illness and premature death is staggering, the issue has been neglected in the debates on healthcare resources and rationing. This week a working party of the Royal Pharmaceutical Society of Great Britain publishes its report on medicine taking.2 It was set up to consider the scale and consequences of non-compliance and to make recommendations. Many of our group, which was made up of doctors, pharmacists, nurses, and social scientists, admitted early on that we rarely took medicines as prescribed. Some confessed to abandoning courses of antibiotics after the first day or two. After we reviewed published work it became apparent that non-compliance might be no more deviant behaviour …